22 March 2010

I called that they would several weeks ago even with Brown getting elected, though not without some doubts and recriminations along the way.

Most times it seems, I hate being right. I'm looking forward to employers having to disclose how much health insurance actually costs them, or rather, how much it costs the workers, except that this perfectly reasonable action of disclosing how much a benefit costs us in real wages doesn't take effect for a year. And there's still no substantive individual market for people to take those dollars toward anyway. In fact they may have killed what individual market there was by nuking HSAs. Otherwise, it was a great achievement...

For full clarity, if I had a vote I would have held out until the excise tax on "Cadillac insurance" was restored, even expanded to most of the employer-based market, and catastrophic only health care insurance was still optional, leaving HSAs as viable to help offset costs. Especially in the individual health insurance market over the next several years before the public exchanges get up and running. My only conclusion from that principle is I will never be elected to serve in office because neither of those are broadly popular. Even among Republicans. Despite my misgivings that this won't help control runaway government health related costs or save thousands of lives, I don't think it necessary to hold this one vote against people in office either. Congress has done dumber things that expanded the power or expense of government for quite sometime now (see any US Census commercial for hints... I'd like to know who thought those were a great idea). The primary reason is that the system as it was was quite terrible. Shifting the costs off of employers even marginally, as I suspect this bill or one like it will eventually do, probably represents an improvement, at least in the short term.

It's not a fix and it's probably not even accurate to call this "reform". But it's a start. It's not the direction I'd have chosen to run in, but then this is America. I'm used to Americans being too dumb, or, more charitably, schizophrenic, to know what they want and that costing all of us money.